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Primary Prevention of Cardiovascular Disease Guidelines

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ASPC Manual of Preventive Cardiology

Part of the book series: Contemporary Cardiology ((CONCARD))

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Abstract

Cardiovascular disease (CVD) remains the leading cause of death in the Western world. Despite the improvement in CVD outcomes over the past four decades, the burden of cardiovascular risk factors remains high. Consequently, death rates from CVD rose in 2015 by 1%, the first rise since 1999. Less than one-fifth of US adults live an ideal heart-healthy lifestyle or have favorable risk factor profiles, which highlights a significant health gap in primary prevention. The AHA/ACC released new comprehensive guidelines for primary prevention, which encompasses recommendations for screening, identifying, and treating patients at risk for CVD. With growing evidence on the importance of lifestyle choices in CVD health, maintaining a healthy lifestyle remains at the center of primary cardiovascular prevention recommendations. This includes recommendations regarding diet, exercise and healthy weight. Accurate CVD risk assessment is the first step in guiding prevention efforts. The use of risk-enhancing factors and coronary artery calcium scoring are new additions to the guidelines and useful to further risk stratify patients in whom the benefit of statin therapy is still uncertain. There is now more emphasis on a team-based approach to CVD risk factor modification, shared decision making between patient and clinician, and, attention to the social determinants of health. The new recommendations for aspirin in primary CVD prevention allow a more targeted use given recent evidence of higher-than-anticipated risk of bleeding in the primary prevention population. Here we discuss the 2019 ACC/AHA Guideline of Primary Prevention of CVD in a simple, ABCDE-structured approach. The goal is to help clinicians implement best practices of primary prevention using this simple framework.

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Authors and Affiliations

  1. Department of Medicine, Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Aparna Sajja, Abdulhamied Alfaddagh & Roger S. Blumenthal

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  1. Aparna Sajja
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  2. Abdulhamied Alfaddagh
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  3. Roger S. Blumenthal
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Correspondence to Roger S. Blumenthal .

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Editors and Affiliations

  1. Heart Disease Prevention Program, Division of Cardiology, University of California, Irvine, Irvine, CA, USA

    Nathan D. Wong

  2. Division of Cardiovascular Medicine, University of California, Davis, Sacramento, CA, USA

    Ezra A. Amsterdam

  3. Cicarrone Center for the Prevention of Cardiovascular Disease, John Hopkins University School of Medicine, Baltimore, MD, USA

    Peter P. Toth

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Sajja, A., Alfaddagh, A., Blumenthal, R.S. (2021). Primary Prevention of Cardiovascular Disease Guidelines. In: Wong, N.D., Amsterdam, E.A., Toth, P.P. (eds) ASPC Manual of Preventive Cardiology. Contemporary Cardiology. Springer, Cham. https://doi.org/10.1007/978-3-030-56279-3_26

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  • DOI: https://doi.org/10.1007/978-3-030-56279-3_26

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